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General NPI Number Information
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NPI Number | 1346696432
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Entity Type | Organization
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Legal Business Name | DEBRA A STATES, LLC
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Dates
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Enumeration Date | 05/09/2016
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Last Update Date | 08/18/2022
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Provider Practice Location Address
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Address Line | 608 MIFFLIN ST
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City | HUNTINGDON
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State | PA
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Zip | 16657
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Country | US
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Telephone | 814-386-9984
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Fax | 814-299-7320
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Provider Business Mailing Address
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Address Line | 15428 RAYSTOWN RD
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City | JAMES CREEK
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State | PA
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Zip | 16657-8705
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Country | US
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Telephone | 814-386-9984
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Fax | 814-299-8467
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Authorized Official
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Title or Position | PRACTITIONER/OCCUPATIONAL THERAPIST
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Name | DEBRA A STATES
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Credential | OTR/L CLT MFRP
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Telephone | 814-386-9984
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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